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Training and Supervision

New to CHC’s Generalist Psychology Training Program

The Post-Doctoral Residency Program at Community Health Center Inc. has been training residents for ten years in the provision of outpatient treatment across the lifespan in a primary care integrated behavioral health setting.  This generalist training meets the needs of working with a diverse population. Over the years, residents have requested the opportunity to delve deeper into specific areas of interest.  As we enter our eleventh year of training residents, we are launching two specialized concentrations, in addition to the generalist approach to training.

Addiction Psychology Concentration

The Addiction Psychology Concentration will focus on providing the resident with specific skills to assess, understand, appropriately refer, and treat clients with substance use disorders (SUD) including opioid use disorder (OUD). Residents in this concentration will participate in co-facilitating and/or leading a Medication Assisted Treatment (MAT) group and will be provided didactic training specific to SUD/OUD.  Residents will also engage in the Weitzman Institute’s MAT ECHO, integrated care meetings for MAT patients at CHC, and will be provided supervision specific to working with patients with a substance use disorder. Residents in the Addiction Psychology concentration will receive additional training on Motivational Interviewing and will be given direct feedback on their MI skills from CHC’s Clinical Director of Substance Use Disorder Services. Residents will also participate in observations of community-based recovery activities, including attending peer support meetings such as Narcotics Anonymous (NA), Alcoholics Anonymous (AA), and Celebrate Recovery, to help gain an understanding of the broader culture of recovery. Residents in this concentration will complete a rotation through CHC’s Wherever You Are (WYA) program and provide direct care to patients with an SUD in our shelter settings. Additional training opportunities at conferences will be made available and residents in this concentration will be encouraged to seek educational opportunities at conferences that provide more information on the neuroscience of addiction as well as novel approaches to MAT.  The purpose for developing this specialized area of training is to contribute to the development of a workforce of psychologists trained in the integrated behavioral health model of care with specialized experience in the treatment of clients who are living with substance use disorders.

Child and Adolescent Concentration

The Child and Adolescent Concentration will focus on providing the resident with specific skills, interventions, and supervision related to treating children, adolescents, and their families.   Residents in this concentration have an opportunity to be placed at one of CHCI’s Hartford, Middletown, Stamford sites and/or in one of the School Based Health Centers located across the state of Connecticut. At the Hartford site all clients are 18 years old or younger, the Middletown site houses the Lillian Reba Moses Child Guidance Clinic, the Stamford sites include the Child Guidance Center of Southern Connecticut, and School Based Health Centers are located in nearly 100 schools across Connecticut.  Those working in this area may have the opportunity to receive training and participate in evidence-based programs like Trauma Focused Cognitive Behavioral Therapy (TF-CBT)  or Cognitive Behavioral Intervention for Trauma in Schools (CBITS).  Residents will be trained in and administer Multidisciplinary Evaluations (MDEs): evaluations of all children newly taken into custody by the Department of Children and Families (DCF).  This intervention uses a variety of developmental and psychosocial measures in conjunction with medical and dental providers.  Supervision for residents in this concentration will be provided by CHC psychologists with specialized experience in the treatment of children, adolescents, and their families. Residents will be able to attend community meetings and conferences, such as the Annual Connecticut Children’s Trauma Conference. Additionally, in accordance with our mission to treat SUD/OUD, residents in this track will receive specific training related to the treatment of SUD/OUD and adolescents, and how to treat families dealing with SUD/OUD.  The purpose of this concentration is to contribute to the development of a workforce of psychologists trained to the integrated behavioral health model of care with specialized experience in the treatment of children and adolescents and their families.

Training

Residents will have the opportunities to:

  • Conduct individual, family/couples and group therapy in a primary health care setting
  • Receive opioid use disorder/substance user disorder specific assessment and treatment training
  • Residents are trained to provide tele-behavioral health via remote delivery to CHC’s patient population
  • Participate in Program-specific clinical team meetings
  • Take part in weekly didactic training seminar
  • Receive training in the use of an integrated electronic health record and Performance Improvement processes
  • Learn and utilize telehealth initiatives to treat clients
  • Participate in developing supervision skills through collaboration with externs’ supervision
  • Work closely with medical and dental providers as part of CHC’s model of integrated care in a Patient Centered Medical Home
  • Participate in weekly multidisciplinary clinical team meetings with other behavioral health disciplines
  • Develop clinical and assessment skills with clients of all ages in a variety of settings, including in primary health care settings, with the opportunity to work in alternate settings such as schools, homeless shelters and domestic violence shelters for “Wherever You Are” clinical care
  • Gain or build upon experience using electronic health records and other state-of-the-art technologies to manage and deliver care
  • Participate in a range of training seminars. See an example list here
  • Participate in a bi-weekly Quality Improvement seminar to learn process improvement skills to apply to clinical practice
  • Participate in quality improvement initiatives offered by the agency such as the Institutional Review Board (IRB), Behavioral Health Quality Improvement Team (BHQI), and Agency Wide Performance Improvement Team (PI)
  • Receive clinical and administrative support consistent with other behavioral health clinicians
  • Participate in research

Specific trainings in the following concentration areas will be offered, through didactics, presentation from experts in the field, online and in-person sessions, as well as practical field experience:

  • SUD/OUD
  • Tele-behavioral health
  • Trauma informed care across the life span
  • Professional and ethical concerns in treatment
  • Child and adolescent focused therapy
  • Facilitation of Groups
  • Multicultural Considerations
  • Psychiatry
  • Risk Assessment
  • Integrated Care
  • Quality Improvement
  • Supervision Mini-Series
  • Adult focused therapy

Supervision

Provided by psychologists licensed by the state of Connecticut.

  • Weekly individual supervision as required by Connecticut licensing law
  • Residents receive two hours of individual supervision with two different supervisors (one in person supervision and/or virtual supervision)
  • One-hour of weekly group supervision for all postdoctoral residents
  • CHC psychologists work at our sites across Connecticut. Each resident will have a primary supervisor affiliated with the site where he or she is located. Secondary supervisors may work at a secondary location
  • Didactic training is provided by the multidisciplinary team at CHC. This includes but is not limited to psychologists, social workers, medical doctors, and advanced practice registered nurses

Requirements for Licensure in U.S.

CHC is willing to adjust supervision hours, ensure supervisor requirements are met, as well as adjust total number of contact hours to meet all requirements for all 50 US states.

Aim Statement

The aim of the postdoctoral residency program at Community Health Center, Inc., is to produce professional psychologists equipped to serve individuals, families, and groups in a patient-centered medical home model, utilizing essential skills requisite of an advanced behavioral health clinical practitioner in an integrated primary care setting. The intention of the postdoctoral residency program is to develop professional, clinical, ethical, quality improvement, supervision, leadership and cultural skills under supervision and to provide a means for cultivating a resident’s professional identity as a clinician, a functioning member of a clinical team, and a community member.  Upon graduation from the residency, individuals will be able to confidently, ethically, and with cultural competency, provide psychotherapy to diverse underserved clients with various backgrounds across the lifespan.  Residents will enhance their capacity to provide care through a wide range of services and methods to improve the physical and emotional health of the individuals and communities in which we serve.  See below for our aim statement and revised competencies.

1.   Integration of Science and Practice

  • Displays clinical skills with a wide variety of clients and uses good judgment especially in unexpected or difficult situations, including but not limited to: clients across the lifespan, varying diagnoses, and populations.
  • Expresses an understanding of empirically supported treatments to inform therapeutic interventions.
  • Demonstrates the flexibility to adapt interventions where appropriate.
  • Exhibits an understanding of the external factors that contribute to health related behaviors.
  • Addresses psychosocial issues that arise from external factors of clients’ environments as part of the therapeutic process. 
  • Provides diagnoses to clients that are clear, relevant and accurate, as well as provides comprehensive justifications for those diagnoses.
  • Independently plans interventions, case conceptualizations and interventions are specific to case and context.
  • Evaluates treatment progress and modifies treatment planning as indicated.
  • Maintains an advanced level of knowledge and skill in treatment of chronic health conditions, such as OUD/SUD, through application of evidence based intervention models.
  • Understands that there are multiple approaches to conducting a clinical interview for assessment and treatment planning, and knows when to implement different approaches under certain contexts.

2.  Individual and Cultural Diversity

  • Independently monitors cultural awareness of self (including an understanding of how their own personal/cultural history, attitudes, and biases may affect how they understand and interact with people different from themselves) and seeks appropriate consultation if there is a gap in this awareness.
  • Demonstrates ability to address differences in client’s intersecting identities as they arise in treatment. Applies a framework for working effectively within areas of individual and cultural diversity not previously encountered over the course of their careers.
  • Demonstrates ability to address differences in colleagues’ intersecting identities as they arise in treatment, including the ability to integrate awareness and knowledge of individual and cultural differences in the conduct of professional roles (e.g., research, services, and other professional activities). Applies a framework for working effectively with areas of individual and cultural diversity not previously encountered over the course of their careers.
  • Incorporates diversity considerations, including but not limited to: ethnicity, race, gender, age, developmental stage, religion, disability, socioeconomic and sexual identity, when conceptualizing and diagnosing clients.
  • Demonstrates knowledge of the current theoretical and empirical knowledge base as it relates to addressing diversity in all professional activities, including research, training, supervision, consultation, and service.

3.  Ethical and Legal Standards

  • Independently utilizes ethical decision-making in all professional activities, acting in accordance with the APA Ethical Principles of Psychologists and Code of Conduct.
  • Understands the ethical and legal considerations related to a client’s needs and can apply ethical decision- making processes in treating the client.
  • Proactively assesses and documents safety risk and interventions, including but not limited to: concerns of suicidality, homicidality, and suspicion of abuse.
  • Seeks consultation in crisis or clinically acute situations.
  • Addresses any exceptions that arise in the limits of confidentiality in client situations.
  • Documentation reflects expectations based on agency, professional, state, federal, and insurance laws, regulations, rules, policies, standards, and guidelines, including but not limited to: objectives being specific and measurable in the care plan, goals in the care plan being in the patient’s own words, and care plan reviewed consistently in the expected interval (30, 60, then 90 days thereafter).
  • Perceives the significance and demonstrates proficiency in the utilization of only HIPAA compliant platforms in provision of mental health care, including telehealth and other service delivery methods.

4. Primary Care and Integrated Service Delivery

  • Gathers relevant information during Warm Handoff visits in order to respond to the requesting provider in a succinct and timely manner.
  • Uses the integrated electronic health record to communicate with other health professionals and clients in an appropriate manner.
  • Applies behavioral health knowledge when identifying, screening, assessing, and diagnosing behavioral health needs as part of a primary care team.
  • Addresses a client’s psychosocial factors, including but not limited to: food insecurity, housing insecurity, community supports, employment, and any other related environmental stressors when treating the client.
  • Demonstrates the ability to address behavioral health concerns in the primary care setting, including but not limited to: anxiety, trauma related disorders, mood disorders, insomnia, psychosis, substance use, violence, and attention concerns in collaboration with other healthcare providers.
  • Demonstrates the ability to provide behavioral health related feedback to common medical concerns in the primary care setting, including but not limited to: type II diabetes, chronic pain conditions, obesity, multiple sclerosis, HIV, and hepatitis-C.

5. Conducting Group Treatment

  • Independently leads a group of three patients or more on at least two occasions.
  • Conducts pre-group evaluations over the phone or telehealth video to establish rapport with patient and evaluate appropriateness for group.
  • Appropriately refers clients to colleagues’ groups, and follows up with their referrals regularly, as well as advertises, explains, and elicits referrals from other staff members and clients, including but not limited to other behavioral health clinicians, medical providers, and patient service associates.
  • Understands the steps to preparing, planning, and starting a group.
  • Distinguishes between clients who are appropriate and inappropriate for the group modality of treatment.
  • Documents group notes and treatment plans effectively
  • As a group facilitator, works to be inclusive of all members in the group process and comfortably addresses group dynamics as they arise.

6. Interpersonal Skills and Professional Development

  • Verbal, nonverbal, and written communications are professional, informative, articulate, succinct, and completed in a timely manner (within forty-eight hours). 
  • Proactively addresses colleague conflicts in the workplace and seeks consultation when appropriate.
  • Proactively addresses client ruptures, understands their role and the client’s in the situation, and seeks consultation when appropriate.
  • Conducts self in a professional manner across settings and situations.
  • Demonstrates receptivity to corrective and constructive feedback from supervisors and staff as demonstrated by their verbal and non-verbal responses, and taking accountability is observed through their actions to resolve the matter.
  • Provides feedback to supervisors and staff using effective and constructive feedback approaches.
  • Exhibits the ability to reflect on one’s reactions and behaviors in different interpersonal interactions.
  • Provides formal presentations on clinical topics in an organized, well-informed, professional and proficient way.
  • Contributes and collaborates effectively in team-based settings.

7.  Supervision Development

  • Articulates awareness of identity and value differences among trainee, self and clients, and articulates how these differences may affect dynamics between these groups.
  • Fosters the trainee’s consciousness of the identity and value differences among the resident, the trainee and the clients, and address these differences in therapy.
  • Develops a supervisory alliance despite potential differences between supervisor and trainee.
  • Shows awareness of supervisory developmental models and provides support to the trainee in a way that meets their current developmental need.
  • Demonstrates the ability to provide both formative and summative feedback to trainee.
  • Actively applies ethical, legal, and administrative considerations related to supervision of a trainee.

8.  Quality Improvement

  • Demonstrates knowledge of quality improvement processes and relevant healthcare innovations within an integrated healthcare service system.
  • Systematically analyzes and utilizes appropriate tools to measure quality and impact of changes within an integrated healthcare service system.
  • Contributes to performance improvement by identifying areas for change (e.g., issues related to clinical workflow) and uses appropriate quality improvement procedures to facilitate the change process.

9. Professional Presentation on Telehealth and Telepresence

  • Presents professionally while delivering telehealth services, including the use of appropriate lighting, camera angle, professional attire and appearance, professional virtual setting, and clear audio and picture quality.
  • Actively engages in virtual team meetings and communicates effectively with behavioral health, medical, leadership and other staff using synchronous and a-synchronous forms of communication to enhance collaboration and treatment outcomes.
  • Creates a strong virtual professional environment in such ways as displaying professional credentials, setting up professional voicemail, and communicating absences, with their team and clients.

10. Providing Effective Clinical Care over Telehealth

  • Communicates clearly with clients and forms therapeutic alliances on both phone and video.
  • Accurately assesses and monitors symptoms virtually and tailors the treatment plan as appropriate.
  • Conducts and adapts evidence-based treatments via telehealth. Explains and delivers exercises using virtual mediums, or uses technology to provide psychoeducation and explain key concepts to clients.
  • Utilizes technological features such as those provided by Zoom, including but not limited to: sharing their screen and utilizing the white board function, to augment their treatment when appropriate.

11. Professional Boundaries and Ethics in Telehealth

  • Proactively addresses professional boundaries and challenges due to limited control over the client’s environment, including but not limited to: discussing appropriate client attire, the client being in an appropriate setting (i.e. not driving, in a quiet environment.), and clarifying expectations regarding others in the room and their expected participation during the session.
  • Sets appropriate boundaries and limits with clients regarding text communication, email, and other forms of online communication.
  • Follows and adheres to all Connecticut regulations regarding telehealth, HIPAA compliance, including not recording telehealth sessions and other rules.

12. Technical Implementation and Technical Support

  • Routinely assists clients in developing their competency with technology to establish secure audio, video, and network connections to maximize the telehealth experience.
  • Provides technical support to clients by assisting them in navigating minor technical challenges; assists clients with video capability to use video consistently, and effectively transitions to telephonic appointments when technical difficulties cannot be resolved or when a client does not have video capability.
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